There are arguments for determinism. Admittedly, this is opposed by the fact of everyday experience of autonomy. In the following, it is argued for the compatibility of determinism and autonomy. Taking up considerations of Donald MacKay, a fatalistic attitude can be refuted as false. Repeatedly, attempts have been made to defend the possibility of autonomy with reference to quantum physical indeterminacy. But its statistical randomness clearly misses the meaning of autonomy. What is decisive, on the other hand, is (...) the possibility of knowledge, which opens up opportunities for planning, freedom of choice and ultimately 'self-choice'. Results of neurobiological research, especially Benjamin Libet's and more recently John-Dylan Haynes', seem to refute this: Actions are unconsciously initiated before conscious decision. But, as Libet has also shown, consciousness always has the possibility of a veto – and thus also of knowledge-driven action control. Ultimately, the idea of possible self-choice can thus become the determining condition. Only such a form of rational self-determination establishes a spiritual identity and at the same time represents the maximum of autonomy possible for human beings. (shrink)

The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justification requirement prohibits public officials from (...) appealing to controversial conceptions of the good life, liberals committed to this principle face a significant puzzle. (shrink)

Government agencies and nonprofit organizations have increasingly turned to randomized controlled trials (RCTs) to evaluate public policy interventions. Random assignment is widely understood to be fair when there is equipoise; however, some scholars and practitioners argue that random assignment is also permissible when an intervention is reasonably expected to be superior to other trial arms. For example, some argue that random assignment to such an intervention is fair when the intervention is scarce, for it is sometimes fair to use a (...) lottery to allocate scarce goods. We investigate the permissibility of randomization in public policy RCTs when there is no equipoise, identifying two sets of conditions under which it is fair to allocate access to a superior intervention via random assignment. We also reject oft-made claims that alternative study designs, including stepped-wedge designs and uneven randomization, offer fair ways to allocate beneficial interventions. (shrink)

According to the norm of policy equipoise, it is permissible to randomly assign participants to two or more interventions in a public policy randomized controlled trial (RCT) when there is meaningful uncertainty among the relevant expert community regarding which intervention is superior. While this norm is gaining traction in the research ethics literature, the idea of interventional superiority remains unclear. Is one intervention superior to another if it is reasonably expected to realize one outcome of interest more effectively, even though (...) there is uncertainty regarding other outcomes of interest? Or must an intervention be reasonably expected to realize all outcomes of interest more effectively? I address this question in this paper. My aim is to develop and defend an account of interventional superiority for policy RCTs that are authorized, funded, or conducted by government institutions. I defend the greatest value view, according to which one intervention is superior to another if and only if it is reasonably expected to more effectively realize a set of outcomes with greater value. (shrink)

A principal rationale for public policy is to address market failures. Pareto efficiency is therefore a highly common and relatively non-controversial evaluative criterion for many policy analyses and is discussed at length in policy analysis texts. This makes sense, for Pareto improvements involve making at least one person better off without making anyone worse off. Who could object to that? But does efficiency deserve the prominence it enjoys in public policy? Is one policy option better than another, at least in (...) one respect, simply because it is more Pareto efficient? Or, is efficiency valuable for some other reason? In this chapter, I discuss Pareto efficiency as an evaluative criterion and argue that it is a stand-in for a more foundational criterion: wellbeing. I begin with an overview of Pareto efficiency, discuss the various ways in which it is operationalized to evaluate policy options, and argue that it is valuable insofar as more efficient states of affairs promise more wellbeing than less efficient states of affairs. I then raise questions regarding whether the conception of wellbeing presupposed by Pareto efficiency – preference satisfaction – is a defensible conception of wellbeing. I go on to introduce three alternative conceptions of wellbeing which have been proposed and defended by both philosophers and policy scholars, namely, hedonism, objective goods views, and the capability approach, and suggest ways in which each can be operationalized as an evaluative criterion. I close by discussing four ‘theory-free’ approaches to thinking about the impact of policies on the quality of people’s lives. Such approaches reject the idea that there is one single theory of wellbeing that should be used to evaluate policy options, and instead develop ways to evaluate the impact of policies on people’s lives that are not grounded in a specific theory. (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

Social scientists and research ethicists have begun, somewhat belatedly, to confront and address the ethical challenges raised by public policy experiments. In doing so however, they have not fully availed themselves of the large and sophisticated literature on the ethics of clinical research which has developed over the past 40 years. While clinical and public policy research are different, I argue that the clinical research ethics literature yields valuable insights for discussions of the ethics of policy experiments. Focusing on seven (...) ethical issues which have received a good deal of attention in public and scholarly discussions of the ethics of policy experiments, I make use of the history of reflection on the ethics of clinical research to provide guidance to researchers planning and conducting policy experiments. (shrink)

In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging before (...) considering proposals to use nudges to increase the number of registered organ donors, including opt-out donor registration systems and the use of “nudge statements.” In part 2, we discuss the use of nudges to influence the decision-making of family members in circumstances where they have a veto over the donation of their loved one’s organs. (shrink)

The field of public policy is dominated by the social sciences. Schools and departments of public policy and public administration are largely populated by economists, political scientists, and sociologists, and the vast majority of work in prestigious public policy journals employs empirical methods. This is unsurprising, in one respect, for collecting data, predicting and identifying the causal impacts of policies, and understanding political institutions and processes are massive, important tasks that require the tools of the social sciences. It is surprising, (...) in another respect however, since much policy scholarship and analysis aspires to offer recommendations to policymakers, and recommendations necessarily involve evaluative judgments, for example, that the status quo is deficient and that a certain course of action will make things better. To defend such judgments, policy scholars and analysts cannot appeal to the social sciences alone for these judgments concern the realm of values, not facts. Instead, careful ethical reflection and analysis is required. This need for ethical reflection in public policy is particularly evident in the practice of policy analysis, a principal analytic tool of the field. Policy analyses involve the identification of policy problems, the specification of criteria for evaluating possible solutions, and the recommendation that a policy option offers the best balance of trade offs. This identification of bads, the specification of goods policies should realize, and the weighing of these goods with the judgment that policymakers should or ought to pursue this course of action or that, are all deeply ethical activities. Ethical reflection and analysis is thus a constituent feature of policy analysis, and like the amassing of evidence and projection of outcomes, this reflection and analysis may be performed well or badly. The overall aim of this book is to provide students, scholars, and practitioners of public policy with guidance regarding the ethical dimensions of policy analysis. My aim in this chapter is to set the stage, providing an overview of these dimensions. After providing a brief overview of the practice of policy analysis, I identify the steps of an analysis where analysts must make ethical judgments in order to move forward, and fully articulate the ethical questions they must confront and take a position on. (shrink)

Policy analyses begin with a systematic overview of the policy problem they address. This includes a comprehensive discussion of the nature and context of the problem, and the institutional and behavioral factors responsible for its emergence. Problem statements must also explain why the status quo is bad or undesirable, why it is something that governments, rather than private actors, should address, and establish that the relevant government institutions have the legitimacy to intervene. In this chapter, I provide an overview of (...) the principal types of policy problems that it is morally appropriate for governments to address. Each type denotes a class of states of affairs that (1) are bad, undesirable, or unjust, (2) the government is particularly well-suited to address, and (3) arise from spheres of action over which the relevant government institutions have the right to intervene. I begin with a discussion of collective action problems, that is, states of affairs in which action by rational and self-interested private actors is collectively self-defeating. I then argue for two additional types of policy problems. First, since the goal of government action is the construction of a just legal order, not merely an efficient one, states of affairs which are unjust constitute an additional type of policy problem. Relatedly, second, whereas analyses of collective action problems typically presuppose the existence of effective government institutions which can address them, such institutions may be deficient and/or unjust. A third type of policy problem is therefore deficient government institutions. -/- . (shrink)

Soda taxes are controversial. While proponents point to their potential health benefits and the public projects that could be funded with their revenue, critics argue that they are paternalistic and regressive. In this paper, we explore the prospects for designing a just soda tax, one that appropriately balances the often-competing ethical considerations of promoting social welfare, respecting people’s autonomy and ensuring distributive fairness. We argue that policymakers have several paths forward for designing a just soda tax, but that the considerations (...) relevant to ethical policy design are more complicated than is sometimes acknowledged. (shrink)

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a (...) policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

Governments are increasingly using randomized controlled trials (RCTs) to evaluate policy interventions. RCTs are often understood to provide the highest quality evidence regarding the causal efficacy of an intervention. While randomization plays an essential epistemic role in the context of policy RCTs however, it also plays an important distributive role. By randomly assigning participants to either the intervention or control arm of an RCT, people are subject to different policies and so, often, to different types and levels of benefits. In (...) this paper, I identify one necessary condition as well as a set of sufficient conditions for the permissible use of random assignment by government agencies. I argue first that random assignment is permissible only if it is consistent with governments’ duty to realize morally important outcomes. I argue second that random assignment is permissible in cases where investigators are in a state of genuine equipoise regarding all arms of the experiment and the policy to which people have a claim of justice. Finally, I defend a set of conditions under which random assignment is permissible in cases where one or more arms of a policy RCT are reasonably expected to be either superior or inferior to this policy. (shrink)

Australia, Canada, and New Zealand currently apply health requirements to prospective immigrants, denying residency to those with health conditions that are likely to impose an “excessive demand” on their publicly funded health and social service programs. In this paper, I investigate the charge that such policies are wrongfully discriminatory against persons with disabilities. I first provide a freedom-based account of the wrongness of discrimination according to which discrimination is wrong when and because it involves disadvantaging people in the exercise of (...) their freedom on the basis of morally arbitrary features of their identity. Discrimination is permissible, I suggest, when it is necessary to advance a valuable exercise of the discriminating agent’s freedom. I then apply this account to the case of social cost health requirements. Against critics of these requirements, I argue that it is sometimes permissible for states to discriminate against prospective immigrants with disabilities. States may do so, I suggest, when such discriminatory treatment is necessary to prevent an increase in rates of mortality and/or morbidity amongst citizens. Alongside critics of social cost health requirements however, I argue that existing policies are likely a form of wrongful discrimination insofar as they are too broad to satisfy this standard. (shrink)

The duty to rescue is a highly plausible and powerful ethical principle. It requires agents to assist others in extreme need in cases where doing so does not conflict with some weighty moral aim; requires little personal sacrifice; and is likely to significantly benefit the recipients.1 As a general obligation, it binds all persons simply qua persons, and it is owed to all persons simply qua persons. Clinical investigators working in low-income countries frequently encounter sick or destitute people to whom (...) they might possess a duty to rescue. Investigators may often ask themselves, what can I do, what should I do, to help? Such investigators often help people in the future by carrying out their... (shrink)

In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be considered a social primary (...) good. We argue second that including the social bases of health as a social primary good would lead the parties to the original position to choose an additional principle of justice and assign it lexical priority over Rawls's second principle. According to this principle, inequalities in people's share of the social bases of health are to be arranged so as to improve the health status of those least advantaged on the social health gradient. -/- . (shrink)

Many high-income countries have skill-selective immigration policies, favoring prospective immigrants who are highly skilled. I investigate whether it is permissible for high-income countries to adopt such policies. Adopting what Joseph Carens calls a " realistic approach " to the ethics of immigration, I argue first that it is in principle permissible for high-income countries to take skill as a consideration in favor of selecting one prospective immigrant rather than another. I argue second that high-income countries must ensure that their skill-selective (...) immigration policies do not contribute to the non-fulfillment of their duty to aid residents of low-and middle-income countries. (shrink)

Journal of Political Philosophy, EarlyView.

The concept of metaphor as primarily a vehicle for conveying ideas, even if unusual ones, seems to me as wrong as the parent idea that a metaphor has a special meaning. I agree with the view that metaphors cannot be paraphrased, but I think this is not because metaphors say something too novel for literal expression but because there is nothing there to paraphrase. Paraphrase, whether possible or not, inappropriate to what is said: we try, in paraphrase, to say it (...) another way. But if I am right, a metaphor doesn't say anything beyond its literal meaning. This is not, of course, to deny that a metaphor has a point, nor that that point can be brought out by using further words.... My disagreement is with the explanation of how metaphor works its wonders. To anticipate: I depend on the distinction between what words mean and what they are used to do. I think metaphor belongs exclusively to the domain of use. It is something brought off by the imaginative employment of words and sentences and depends entirely on the ordinary meanings of those words and hence on the ordinary meanings of the sentences they comprise. Donald Davidson is University Professor of philosophy at the University of Chicago. He is the author of many important essays, including "Actions, Reasons and Causes," "Causal Relations," and "Truth and Meaning," coauthor of Decision-Making: An Experimental Approach, and coeditor of Words and Objections, Semantics of Natural Language, and The Logic of Grammar. (shrink)

Governments often aim to improve children’s wellbeing by targeting the decision-making of their parents. In this paper, I explore this phenomenon, providing an ethical evaluation of the ways in which governments target parental decision-making in the context of anti-poverty policies. I first introduce and motivate the concept of parent-targeted paternalism to categorize such policies. I then investigate whether parent-targeted paternalism is ever pro tanto wrong, arguing that it is when directed at parents who meet a threshold of parental competency. I (...) next explore the factors that affect the degree of pro tanto wrongness of paternalistic anti-poverty policies targeting parents, and provide an account of the conditions under which such policies are on balance permissible, and when they are not. Finally, I illustrate the plausibility and usefulness of my framework by considering a case. (shrink)

Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under which informed consent is required for ethical policy research conducted (...) or authorized by government. We argue that investigators need not secure participants' informed consent when conducting government policy experiments if: the government institution conducting or authorizing the experiment possesses a right to rule over the spheres of policy targeted by the research; and data collection does not involve the violation of participants' autonomy rights. (shrink)

The federal system for allocating donated livers in the United States is often criticized for allowing geographic disparities in access to livers. Critics argue that such disparities are unfair on the grounds that where one lives is morally arbitrary and so should not influence one's access to donated livers. They argue instead that livers should be allocated in accordance with the equal opportunity principle, according to which US residents who are equally sick should have the same opportunity to receive a (...) liver, regardless of where they live. In this paper, we examine a central premise of the argument for the equal opportunity principle, namely, that geographic location is a morally arbitrary basis for allocating livers. We raise some serious doubts regarding the truth of this premise, arguing that under certain conditions, factors closely associated with geographic location are relevant to the allocation of livers, and so that candidates' geographic location is sometimes a morally non-arbitrary basis for allocating livers. Geographic location is morally non-arbitrary, we suggest, since by taking it into account, the UNOS may better fulfill its central goals of facilitating the effective and efficient placement of organs for transplantation and increasing organ donation. (shrink)

The work argues that engaging Africa's cultural and epistemic resources as social imaginaries, and not as metaphysical or ontological “essences,” could help practitioners of African philosophy overcome the cluster of shortcomings and undesirable features associated with “ethnophilosophy.” A number of points are outlined to buttress this claim. First, the framework of social imaginaries does not operate with the false assumption that Africa's cultural forms and epistemic resources are static and immutable. Second, this framework does not lend itself to sweeping generalizations (...) about Africa or large swathes of it. Third, the framework of social imaginaries remedies ethnophilosophy's problem of collectivism. Fourth, unlike ethnophilosophy, it does not romanticize and canonize a supposedly “idyllic” African past, which militates against a realistic and forward‐looking philosophizing. Finally, with the framework of social imaginaries, Africa's indigenous cultural and epistemic resources become amenable to being engaged with critical philosophical rigor. This not only enhances their potential for cross‐cultural philosophical conversation but also enhances their usefulness for addressing current sociopolitical issues affecting Africa. The discussion in this paper somewhat touches upon the question of method in African philosophy, using the ethnophilosophy problem to navigate the vast gamut of issues involved. (shrink)

This chapter provides a critical overview and interpretation of fair subject selection in clinical and social scientific research. It first provides an analytical framework for thinking about the problem of fair subject selection. It then argues that fair subject selection is best understood as a set of four subprinciples, each with normative force and each with distinct and often conflicting implications for the selection of participants: fair inclusion, fair burden sharing, fair opportunity, and fair distribution of third-party risks. It then (...) defends an approach to navigating the conflicting imperatives of these subprinciples, one which privileges the need to include epistemically distinct groups in research, before concluding by considering the most pressing research questions regarding fair subject selection. (shrink)

Two things become one thing, something having parts, and something becoming something else, are cases of many things being identical with one thing. This apparent contradiction introduces others concerning transitivity of identity, discernibility of identicals, existence, and vague existence. I resolve the contradictions with a theory that identity, number, and existence are relative to standards for counting. What are many on some standard are one and the same on another. The theory gives an account of the discernibility of identicals using (...) phrases like “insofar as”. And it holds that standards for counting remain or shift depending on our purposes. (shrink)

According to the Weak Supplementation Principle (WSP)—a widely received principle of mereology—an object with a proper part, p , has another distinct proper part that doesn't overlap p . In a recent article in this journal, Nikk Effingham and Jon Robson employ WSP in an objection to endurantism. I defend endurantism in a way that bears on mereology in general. First, I argue that denying WSP can be motivated apart from the truth of endurantism. I then go on to offer (...) an explanation of WSP's initial appeal, argue that denying WSP fails to have untoward consequences for the rest of mereology, and show that the falsity of WSP is consistent with a primary guiding thought behind it. (shrink)

In this case discussion, Barnhill and Devine collect and present a significant amount of recent research on the various reasons why people struggle to succeed in weight loss programmes. Specifically, the authors focus on what they call ‘behavioural weight loss interventions’, which are ‘research, clinical or public health efforts to promote individual healthy eating and physical activity behaviours’. As defined, this is a very broad category of interventions and presumably includes all kinds of dieting and weight loss programmes or promotion (...) efforts short of private or independently chosen programmes. The authors argue, in a nutshell, that these clinical, research, and public health interventions have low efficacy, and while they may have some health or other benefits, the balance of evidence presented shows that they harm people in multiple ways. (shrink)

Hume’s critique of traditional abstraction entails a result that undercuts his account of the idea of identity. To save his account of identity, Hume would have to accept abstraction as well. What links these two discussions is (1) Hume’s widely shared assumption that traditional abstraction is separating in the mind what are inseparable in reality, (2) his principle that what are different are mentally separable, and (3) his principle that we cannot conceive of the impossible. Given these, it will turn (...) out that abstraction is mentally separating something from itself, which will entail that abstraction is conceiving of something as distinct from itself. But it is impossible for something to be distinct from itself, and so it is inconceivable. Therefore abstraction is impossible. Yet consider Hume’s account of the idea of identity. On that account, to conceive of an identity is to conceive of something as one single thing viewed one way and as two distinct things viewed another. How we can take these opposing views of the same thing is a problem that I’ve termed Hume’s Difficulty concerning Identity. It will turn out that we can take the opposing views only if we can conceive of the single thing viewed one way as somehow distinct from itself when viewed the other way. That is, we must be able to conceive of something as distinct from itself. However, if we cannot conceive of something as distinct from itself when abstracting, then we cannot do it when conceiving of an identity. So traditional abstraction and Hume’s account of the idea of identity stand or fall together. (shrink)

How is it possible for David Hume to be both withering skeptic and constructive theorist? I recommend an answer like the Pyrrhonian answer to the question how it is possible to suspend all judgment yet engage in active daily life. Sextus Empiricus distinguishes two kinds of assent: one suspended across the board and one involved with daily living. The first is an act of will based on appreciation of reasons; the second is a causal effect of appearances. Hume makes the (...) same distinction, only he extends the sort of assent involved in daily life to theoretical matters as well. He is a skeptic both in finding no reason to grant the first sort of assent and in being subject to the second. (shrink)

I argue that an individual has aspects numerically identical with it and each other that nonetheless qualitatively differ from it and each other. This discernibility of identicals does not violate Leibniz's Law, however, which concerns only individuals and is silent about their aspects. They are not in its domain of quantification. To argue that there are aspects I will appeal to the internal conflicts of conscious beings. I do not mean to imply that aspects are confined to such cases, but (...) the best way to start is to recognize them experientially. We can feel the conflicts within ourselves. In doing so we can feel some of our aspects. I will try to enhance our understanding of the concept of aspect by listing and formalizing some principles for its use. After that I will argue that all sorts of individual things have aspects, not just people who are conflicted. (shrink)

The aim of this paper is to consider whether critical rationalism has any ideas which could usefully be applied to the internet. Today we tend to take the internet for granted and it is easy to forget that it was only about two decades ago that it began to be used to any significant extent. Accordingly in section 1 of the paper, there is a brief consideration of the history of the internet. At first sight this makes it looks implausible (...) that any of Popper’s ideas could be applicable to the internet, since Popper died before the internet came into general use. However, section 2 argues that Popper’s theory of World 3 does apply very well to the internet. This application is significant because, as shown in section 3, it leads to the problem of misinformation, which is one of the most significant problems generated by the internet. In section 4 there is an attempt to solve this problem using ideas taken from Popper’s epistemology. It is argued that there should be changes in education designed to prepare students for the internet age. Teaching in the internet age should focus on presenting to the students not just the accepted theories but also the evidence on which they are based. An illustration of how this might be done is given by considering an example from science teaching, namely the teaching of Newtonian mechanics in the last years of school or first years of university. (shrink)

Construing the instantiation of a universal by a particular in terms of my theory of aspects resolves the basic mystery of this "non-relational tie", and gives theoretical unity to the four characteristics of instantiation discerned by Armstrong. Taking aspects as distinct in a way akin to Scotus's formal distinction, I suggest that instantiation is the sharing of an aspect by a universal and a particular--a kind of partial identity. This approach allows me to address Plato's multiple location and One over (...) Many problems, Bradley's problem concerning the instantiation of relations, and the problem of change. (shrink)

This essay interprets Butler’s distinction between identity in the loose and popular sense and in the strict and philosophical sense. Suppose there are different standards for counting the same things. Then what are two distinct things counting strictly may be one and the same thing counting loosely. Within a given standard identity is one-one. But across standards it is many-one. An alternative interpretation using the parts-whole relation fails, because that relation should be understood as many-one identity. Another alternative making identity (...) relative to sort fails, because whole and parts can be of the same sort. (shrink)

There is more than one way to say that composition is identity. Yi has distinguished the Weak Composition thesis from the Strong Composition thesis and attributed the former to David Lewis while noting that Lewis associates something like the latter with me. Weak Composition is the thesis that the relation between the parts collectively and their whole is closely analogous to identity. Strong Composition is the thesis that the relation between the parts collectively and their whole is identity. Yi is (...) right that Strong Composition does not fully reflect my view. We must recognize further what, borrowing Lewis's characterization, could be called the "stronger, and stranger" Composition thesis, or what I'll call the Stronger Composition thesis for short. On Strong Composition, it is only collectively that the parts are identical with the whole. On Stronger Composition, they are individually identical with it as well. I will explain and motivate this thesis. (shrink)

Questions about the morality of lying tend to be decided in a distinctive way early in discussions of Kant’s view on the basis of readings of the false promising example in his Groundwork of The metaphysics of morals. The standard deception-as-interference model that emerges typically yields a very general and strong presumption against deception associated with a narrow and rigorous model subject to a range of problems. In this paper, I suggest an alternative account based on Kant’s discussion of self-deception (...) in the Metaphysics of Morals. I argue that we make the concern with respect for our capacity for inner freedom seen in the case of self-deception the model for deception in general. Focusing on the case of paternalistic lying, I claim that this approach yields a subtle and integrated account that promises the kind of resources we need if we are to be able to make headway with hard cases where deception may seem permissible. (shrink)

As a way to make medical decisions, Evidence-Based Medicine (EBM) has failed. EBM's failure arises from not being founded on real-world decision-making. EBM aspires to a scientific standard for the best way to treat a disease and determine its cause, but it fails to recognise that the scientific method is inapplicable to medical and other real-world decision-making. EBM also wrongly assumes that evidence can be marshaled and applied according to an hierarchy that is determined in an argument by authority to (...) the method by which it has been obtained. If EBM had valid theoretical, practical or empirical foundations, there would be no hierarchy of evidence. In all real-world decision-making, evidence stands or falls on its inherent reliability. This has to be and can only be assessed on a case-by-case basis applying understanding and wisdom against the background of all available facts—the "factual matrix." EBM's failure is structural and was inevitable from its inception. EBM confuses the inherent reliability and probative value of evidence with the means by which it is obtained. -/- EBM is therefore an ad hoc construct and is not a valid basis for medical decision-making. This is further demonstrated by its exclusion of relevant scientific and probative real-world decision-making evidence and processes. It draws upon a narrow evidence base that is itself inherently unreliable. It fails to take adequate account of the nature of causation, the full range of evidence relevant to its determination, and differing approaches to determining cause and effect in real-world decision-making. EBM also makes a muddled attempt to emulate the scientific method and it does not acknowledge the role of experience, understanding and wisdom in making medical decisions. (shrink)

Eleonore Stump has argued that the fulfilment of union between God and human beings requires a mode of relatedness that can be compared to joint attention, a phenomenon studied in contemporary experimental psychology. Stump’s account of union, however, is challenged by the fact that mother Teresa, despite her apparent manifestation of the love of God to others, herself experienced an interior ”dark night of the soul’ during which God seemed to be absent and to have rejected her completely. The dark (...) night of the soul poses a problem for Stump’s account, since, if anyone had a union of divine love with God, it would seem that mother Teresa did. Nevertheless, I argue that the isolation and abandonment of mother Teresa’s dark night are contrary to the conditions assumed to be required for joint attention with God. As an alternative to Stump’s account, I suggest that the dark night of the soul might be better understood by reference to a combination of joint attention and blindsight, according to which interpersonal closeness might be realized through a consistent pattern of external actions without, however, a direct awareness of one person by the other. (shrink)

In 'The Moral Problem', Michael Smith defends a conception of normative reasons that is nonrelative. Given his understanding of normative reasons, nonrelativity commits him to the convergence hypothesis: that, as a result of the process or correction of beliefs and rational deliberation, 'all' agents would converge on having the same set of desires. I develop several reasons for being pessimistic about the truth of this hypothesis. As a result, if normative reasons exist, we have a reason to be skeptical of (...) either Smith's understanding of what normative reasons are or of his insistence that they are nonrelative. (shrink)

ABSTRACT According to David Lewis, alteration is "qualitative difference between temporal parts of something." It follows that moments, since they are simple and lack temporal parts, cannot alter from future to present to past. Here then is another way to put McTaggart's paradox about change in tense. I will appeal to my theory of Aspects to rebut the thought behind this rendition of McTaggart. On my theory, it is possible that qualitatively differing things be numerically identical. I call these differing, (...) numerically identical things "aspects." I will argue that alteration can be a qualitative difference between temporal aspects of something that lacks temporal parts. So a moment can alter in tense. By rejecting Lewis's assumption my theory can solve this version of McTaggart's paradox. (shrink)

Confucius gave counsel that is notoriously hard to follow: "What you do not wish for yourself, do not impose on others" (Huang 1997: 15.24). People tend to be concerned with themselves and to be indifferent to most others. We are distinct from others so our self-concern does not include them, or so it seems. Were we to realize this distinctness is merely apparent--that our true self includes others--Confucius's counsel would be easier to follow. Concern for our true self would extend (...) concern beyond the narrow selves we appear to be. The neo-Confucians held just such a view. They espoused an identity with the universe and everything in it, arguing that this identity explains a natural concern for everyone and everything, not just for our narrow selves. However, many things in the universe differ from each other, that is, some have qualities others lack. If they are all one and the same thing then that one thing differs from itself. I will suggest that the objection can be answered with some metaphysical innovation. I will address the objection by sketching a theory--call it the theory of aspects--that explains how numerically identical things can differ qualitatively. (shrink)

An essay on the compatibility of Jewish and Muslim aspirations for the Land that argues that a vision of peaceful coexistence to provide a spur to the settling of grievances, but that this vision must respect the deeply felt aspirations of both communities, including in particular those underpinned by religious lore. Existing formulations of the aims of each community are blatantly inconsistent; it is time to attempt to characterise the just and religiously authentic goals of each community in ways that (...) are compatible. I argue that there religious and personal dimensions of the conflict that have been displaced by less deep-seated political goals, but which can be addressed more readily. I outline a tiered constitutional settlement that could address legitimate aspirations by avoiding the anathema of partition. (shrink)

Neo-Humean instrumentalists hold that anagent's reasons for acting are grounded in theagent's desires. Numerous objections have beenleveled against this view, but the mostcompelling concerns the problem of ``aliendesires'' – desires with which the agent doesnot identify. The standard version ofneo-Humeanism holds that these desires, likeany others, generate reasons for acting. Avariant of neo-Humeanism that grounds anagent's reasons on her values, rather than allof her desires, avoids this implication, but atthe cost of denying that we have reasons to acton innocent whims. (...) A version of neo-Humeanismthat holds that an agent has reason to satisfyall of her desires that are not in conflictwith her values appears to allow us to grantthe reason-giving force of innocent whims whiledenying the reason-giving force of alien desires. (shrink)

I argue via examples that there are cases in which things that are not two distinct things qualitatively differ without contradiction. In other words, there are cases in which something differs from itself. Standard responses to such cases are to divide the thing into distinct parts, or to conceive of the thing under different descriptions, or to appeal to different times, or to deny that the property had is the property lacked. I show these responses to be unsatisfactory. I then (...) gather and systematize available ways of talking about such cases with phrases like ‘insofar as’, ‘qua’, ‘to the extent that’, ‘in some respect’, etc., while paying special attention to the scope of ‘not’ when used with these phrases. This allows me to show how we can speak of self-differing without contradiction. (shrink)

Medicine, like law, is a pragmatic, probabilistic activity. Both require that decisions be made on the basis of available evidence, within a limited time. In contrast to law, medicine, particularly evidence-based medicine as it is currently practiced, aspires to a scientific standard of proof, one that is more certain than the standards of proof courts apply in civil and criminal proceedings. But medicine, as Dr. William Osler put it, is an "art of probabilities," or at best, a "science of uncertainty." (...) One can better practice medicine by using other evidentiary standards in addition to the "scientific." To employ only the scientific standard of proof is inappropriate, if not impossible; furthermore, as this review will show, its application in medicine is fraught with bias. Evidence is information. It supports or undermines a proposition, whether a hypothesis in science, a diagnosis in medicine, or a fact or point in question in a legal investigation. In medicine, physicians marshal evidence to make decisions on how to best prevent, diagnose, and treat disease, and improve health. In law, courts decide the facts and render justice. Judges and juries assess evidence to establish liability, to settle custody and medical issues, and to determine a defendant's guilt or innocence. (shrink)

Ordinary usage gives a way to think of identity through time: the Pittsburgh of 1946 was the same city as the Pittsburgh of today is--namely Pittsburgh. Problem: The Pittsburgh of 1946 does not exist; Pittsburgh still does. How can they have been identical? I reject the temporal parts view on which they were not but we may speak as though they were. Rather I argue that claiming their identity is not contradictory. I interpret ‘the Pittsburgh of 1946’ as ‘Pittsburgh as (...) it was in 1946’ and suggest that the apparent contradiction results from an ambiguity in the scope of ‘as’. (shrink)

Neo-Humean instrumentalist theories of reasons for acting have been presented with a dilemma: either they are normatively trivial and, hence, inadequate as a normative theory or they covertly commit themselves to a noninstrumentalist normative principle. The claimed result is that no purely instrumentalist theory of reasons for acting can be normatively adequate. This dilemma dissolves when we understand what question neo-Humean instrumentalists are addressing. The dilemma presupposes that neo-Humeans are attempting to address the question of how to act, 'simpliciter'. Instead, (...) they are evaluating actions from the agent's normative perspective. (shrink)